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HEALTH  SCIENCES  STANDARD 


HX64073297 
RA1 22.C1  N482  1 91 7  Facts  and  figures  sn 


RECAP 


New  Xork  (City)  Dept.  of  Health, 
Facts  and  Figures  Showing  the  Quantity 
and  Cost  of  the  Work.  1917  • 


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Columbia  Untorsttp 

College  of  ^fcpstctang  anb  burgeons 
Hiurarp 


Digitized  by  the  Internet  Archive 

in  2010  with  funding  from 

Open  Knowledge  Commons 


http://www.archive.org/details/factsfiguresshowOOnewy 


Wfm^rn, 


O&tittftga  Ds 


SERVICE,  COST  AND  RESULTS 


OF  THE  WORK 
OF  THE 


DEPARTMENT 
OF  HEALTH 


1913—1917 


DEPARTMENT    OF    HEALTH 

OF  THE  CITY  OF  NEW  YORK 

139  CENTRE  STREET 


FACTS   AND   FIGURES 


Showing  the  Quantity  and   Cost 
of  the  Work  of 


The  Department  of  Health 


FOR  A  FIVE-YEAR  PERIOD 

With  a  Summary  of  the  Results 
to  the  Public   Health 


1917 


<_  fy  UJ..C 


S.   S.  GOLDWATER,  M.  D., 

Commissioner  of  Health, 
February  1,   1914,  to  November  22,  1915. 

Haven  Emerson,  M.  D., 

Commissioner  of  Health, 

November  22,  1915,  to  January  1,  1918. 


M.  B.  Brown  Printing  &  Binding  Co., 
New  York. 


Hon.  John  Purroy  Mitchel,  Mayor: 

Sir — Your  administration  will  be  measured  as  much  by  its 
results  in  the  protection  and  saving  of  human  lives  as  by  any 
record  of  accomplishments  in  the  sphere  of  finance,  law  or 
material  equipment  for  transacting  the  city's  business.  Allow  me 
to  offer  herewith  a  brief  record  of  public  health  protection  during 
the  past  four  years,  and  for  comparison  a  statement  of  service 
and  results  in  the  year  with  the  best  previous  record  in  the  city's 
history.  The  confidence  which  you  have  placed  in  the  Depart- 
ment and  the  independence  of  action  in  matters  within  the  sphere 
of  its  technical  work  which  your  administration  has  granted,  have 
been  indispensable  factors  in  whatever  success  has  been  achieved. 
In  reporting  here  upon  my  service  under  your  appointment,  it 
is  a  pleasure  to  pay  full  tribute  to  the  ability  and  devotion  of  the 
Directors  of  the  Bureaus  of  the  Department,  within  their  respec- 
tive fields,  and  to  the  loyalty  of  the  personnel  of  the  Department 
as  a  whole  to  the  best  interests  of  the  city's  health. 

Respectfully, 


Haven  Emerson, 

Commissioner  of  Health. 


December  31st,  1917. 


SERVICE  AND  COST. 

There  has  been  no  increase  in 
the  number  of  employees  in  the 
Department  of  Health  but  de- 
spite this  fact  a  higher  grade  of 
service  and  more  full  time  posi- 
tions in  the  professional  groups 
has  been  provided.  Medical 
supervision  of  the  employees  in- 
augurated in  1914  has  resulted 
in  a  material  reduction  in 
the  number  absent  during  each 
of  the  past  three  years  on  ac- 
count of  illness,  and  further  in  a 
notable  reduction  in  the  percent- 
age of  days  lost  throughout  the 
Department  because  of  illness. 
These  results  lend  great  force  to 
the  argument  already  presented 
to  you  for  a  medical  service  for 
all  city  employees,  a  plan  adopt- 
ed by  almost  all  careful  and  suc- 
cessful private  industries. 

The  per  capita  cost  of  the  De- 
partment service  to  the  taxpayers 
has  been  decreased  and  is  at  a 
point  below  which  it  cannot 
safely  be  reduced  without 
neglect  of  some  or  many  of  the 
fundamental  procedures  and 
precautions  upon  which  a  low 
mortality  and  low  morbidity 
rate  depend.  The  reduction  ef- 
fected holds  good  whether  the 
total  expenditure  is  considered 
or  whether  the  cost  of  operating 
the  hospitals  is  excluded  for  each 
year. 


im 


34Z1 


304Z 


3082 


3066 


1.  Number   of   Employees. 


NO 

■ 

1915 

\m 

1917 

W 

1(10 

\ 

V, 

M 

\ 

?00 

> 

\ 

100 

0 

m 

378 

M 

2.  Number   of   Employees   absent   during 
the  year  on  account  of  illness. 


1915 

1916 

1917 

4% 

I  to 

N 

< 

?i 

\ 

v 

\i 

\ 

o 

3.6 

H 

1.5 

3.- Percentage  of  days  lost  by  Employees 
on    account    oA    illness. 


RATE 

1913 

1911 

1915 

191b 

1917 

•70 

-flh 

.» 

.629 

.617 

.606 

.666 

.611 

AO 

.30 

Mb 

.435 

.130 

.HDD 

.itra 

.71 

-ft- 

4.  Per    capita    cost    of    Dept.    of    Health 
Total                           ■ 
Per    capita    cost    of    Dept.    of    Health 
Exclusive    of    Hospitals     


fisooon 

1913 

1914 

1915 

1916 

1917 

DOMINI 

A 

5OQOO0 

_«"-— ■ 

.y 

f  \ 

\ 

400000 

+* 

^ 

\ 

300  POO 

7D0000 

100  000 

0 

473.413 

517,811 

523.811 

652,389 

488.256 

S.  Patient  days  provided  for  cases  of 
Communicable  Diseases  in  Depart- 
ment   Hospitals. 


» 

1913 

1914 

1915 

1916 

1917 

3000 

s 

* 

2,500 

7000 

moo 

i  fifin 

twtr^ 

500 

0 

2.395 

2,840 

2.920 

3,000 

3.300 

6.  Bed  Capacity  of  Department  Hospitals. 


In  spite  of  the  stationary  force 
and  lower  cost,  certain  notable 
increases  in  service  to  the  city, 
and  a  number  of  important  in- 
novations in  sanitary  supervi- 
sion, have  been  accomplished 
without  sacrificing  any  of  the 
standards  or  established  proced- 
ures of  known  value.  The  in- 
crease in  hospital  accommoda- 
tions is  especially  valuable.  In 
connection  with  these  charts  it 
must  be  remembered  that  1916 
was  a  year  of  special  emergency, 
when  every  resource  of  the  De- 
partment of  Health  hospitals  and 
of  many  private  hospitals  were 
used  to  meet  the  needs  for  hos- 
pital care  of  the  poliomyelitis 
cases.  In  addition  to  the  patient 
days  provided  in  Department  of 
Health  Hospitals  in  1916,  there 
were  36,685  days'  care  provided 
for  poliomyelitis  cases  in  other 
than  Department  of  Health  hos- 
pitals. On  August  21st,  1916, 
a  total  emergency  bed  capacity 
of  3,479  beds  was  provided  in 
Department  hospitals  and  an  ac- 
tual hospital  census  of  3,334  pa- 
tients was  reached.  Of  these 
2,517  were  cases  of  poliomyelitis 
and  817  cases  of  other  communi- 
cable diseases.  It  is  to  be  noted 
that  only  by  having  provision  in 
contagious  disease  hospitals  for 
more  than  the  average  or  even 
the  usual  seasonal  incidence  of 
epidemic  diseases  can  the  com- 
munity danger  from  failure  to 
isolate  such  cases  in  time  of  spe- 
cial prevalence  be  escaped. 


Services  at  the  advisory  clin- 
ics for  venereal  diseases  have 
been  expanded  and  are  now 
available  in  all  boroughs. 

The  diagnostic  laboratories 
have  increased  their  capacity  for 
high  grade  technical  work  with 
no  reduction  in  accuracy  and 
with  great  addition  to  the  con- 
venience of  physicians.  (See 
charts  8,  9,  10,  11  and  12.) 


imn 

1913 

1914 

1915 

1916 

1917 

40,00(1 

30000 

?0000 

10,000 

f- 

0 

6665 

I7.7Z7 

20,173 

22.96Z 

39,255 

7.  Attendance       at       Venereal       Disease 
Advisory    Clinics. 


1913 

1914 

1915 

1916 

1917 

130,000 



170000 

110,001) 

100  OOf 

wooo 

80,000 

70000 

60,00(1 

SO  000 

40  000 

30,000 

70000 

10,00! 

0 

1.533 

41115 

49.ZIZ 

55.ZU 

123,500 

1W),0M 

1913 

1914 

1915 

1916 

1917 

151)  (WO 

•lflflMfl 

130,000 

ill 

110000 

100(1 

-  MP. 

Ml 

b 

80,150 

151,169 

151,115 

133,032 

141,284 

8.   Wassermann  Tests. 


9.   Diagnostic      Examinations      of     Diph- 
theria. 


(913 

19(4 

1915 

1916 

1917 

(U,UUU 

60,000 

50,000 

40,000 

* 

30,000 

9n  nnn 

[u.uuu 

10,000 

0 

4i;64d 

49,761 

61,080 

64603 

54,808 

1913 

1914 

1915 

1916 

i9ir 

?0,fl00 

IS  00(1 

/ 

S 

10000 

7 

s 

■po 

koh 

— / 

0 

- 

9,064 

9,041 

20,102 

17,535 

13,208 

10.   Diagnostic    Examinations    of     Sputum      11.   Diagnostic  Examinations  for  Typhoid, 
for    Tubercle    Bacilli. 


100,000 

J913 

1914 

1915 

1916 

1917 

30,050 

/ 

pa  nnft 

f 

DU.IM 

/ 

70,000 

S 

^r 

60,000 

/ 

50,000 

•s 

*y 

r 

40.000 

^r 

Wflflfl 

20,000 

10.00U 

0 

54,373 

48,382 

67,637 

74,550 

95,732 

In  its  supervision  of  the  milk 
supply,  the  Department  of 
Health  has  greatly  increased  the 
number  of  specimens  examined 
bacteriologically. 


12.  Bacterial    Examinations    o.f   Milk. 


c.c. 

1913 

ma 

1915 

1916 

1917 

(MM 

dOOOOOf 

5090l)0tl 

im 

301)0001 

onnfjnn/ 

' 1 

lopoopo 

1 

3.75X740 

3.761,690 

4504,940 

4.639,575 

6,912,984 

13.     S 


era  produced  for  Diagnostic,  Prophy- 
lactic  and   Therapeutic  Use. 


Owing  to  the  increased  de- 
mand at  home  and  abroad  for 
the  products  of  the  laboratory 
of  the  Department  there  have 
been  made  and  sold  greatly  in- 
creased quantities  of  sera  and 
vaccines  for  diagnostic,  prophy- 
lactic and  therapeutic  use.  (See 
charts  13  and  14.) 


n 

1913 

1914 

1915 

1916 

1917 

?  0(1(1001 

IWO 

100000 

SNW 

1 

800,344 

947.767 

1,309.418 

1,753,479 

1,661,896 

14.   Vaccines     produced     for     Prophylactic 
and   Therapeutic   use. 


With  the  increase  in  the  pub- 
lic school  population  and  the 
addition  of  the  parochial  schools 
to  the  supervision  of  the  De- 
partment, a  greatly  increased 
burden  has  been  thrown  upon 
the  school  medical  inspection 
system.  Quicker  and  invaluable 
results  not  yet  attained  could  be 
had  if  the  pleas  of  the  Depart- 
ment were  heeded  and  a  really 
adequate  force  of  doctors  and 
nurses  were  allowed  for  this 
service. 

The  supervision  of  expectant 
mothers,  one  of  the  most  profit- 
able forms  of  preventive  medi- 
cine, and  one  giving  large  re- 
turns in  the  form  of  a  reduction 
of  maternal  and  infant  mortality, 
has  grown  steadily  and  could  be 
multiplied  many  fold  with  a 
more  liberal  provision  for  med- 
ical and  nursing  service.  The 
same  is  equally  true  of  the 
supervision  of  infants  under 
two  years  of  age. 


mm 

1913 

\m 

1915 

I9I6 

1917 

1000,000 

1     | 

1000 

(■e* 

fiOO.OOO 

11)0,000 

WOO 

0 

843,466 

302,882 

131,392 

329,158 

944,071 

15.   Public  and   Parochial   School   Children 
under    Supervision. 


MOTHER 

,1913 

1914 

191b 

1916 

1917 

5000 

?,m 

/ 

< 

1,800 

J 

f 

1,?00 

/ 

fiflfl 

--- 

0 

1,622 

2,482 

3,002 

2,984 

16.   Expectant  Mothers   Supervised. 


17.   Children     under     2 

under  1 

Health    Stations. 


E and 

attending  Baby 


10 


70000(1 

1913 

1914 

1915 

1916 

1917 

15(1000 

% 

•*.- 

.s 

y 

WOOD 

191,924 

171,158 

17Z.Z45 

202,856 

205,434 

ftOOOO 

11(1(1(10 

0 

64,461 

64,441 

n,n6 

70,919 

80,672 

18.    Searches       in    Bureau       of       Records 
Transcripts       made       from       Records 


1913 

m 

1915 

1916 

1917 

ftCPFS 

1MN 

10,000 

A 

5,000 

y 

'  > 

^ 

r* 

■"»• 

0 

/ 

V 

f 

1,560 

15,000 

54 

7,600 

6,560 

19.  New  acreage  of  marsh  (fresh  or  salt) 
drained  to  prevent  mosquito  breed- 
ing under  contract  and  by  Depart- 
ment  of  Health  force. 


LINEAR 
fPPT 

1913 

1911 

1915 

1916 

1917 

DPI 

K 

111 

r 

\ 

Fill 

A 

, 

1 

\ 

11)11 

> 

(\ 

J 

/ 

V 

KM 

m% 

32,163 

4,359,994 

E,92S71I 

The  natural  growth  of  the 
city  and  many  requirements 
connected  with  the  war  and  the 
draft  have  resulted  in  greater 
demand  upon  the  Registrar  of 
the  Department  for  searches  and 
transcripts  of  records. 


In  completing  the  construc- 
tive engineering  program  for 
the  elimination  of  the  mosquito, 
all  the  large  areas  of  salt  and 
fresh  water  marsh  in  the  city 
limits  have  either  been  drained 
or  filled,  or  the  work  is  con- 
tracted for  and  being  rapidly 
brought  to  completion. 


20.   Linear    feet    of   new    drainage    ditches 
dug  to  prevent  mosquito  breeding. 


11 

The  complete  supervision  of 
stables  is  now  an  accomplished  ^ 
task  and  a  reduction  in  the 
prevalence  of  flies  has  obviously 
taken  place.  In  the  absence  of 
adequate  field  data,  however, 
this  reduction  cannot  be  stated 
statistically. 


11000 

mi 

1914 

1915 

1916] 

1917 

10  050 

MOD 

0,01)0 

7000 

Boon 

5000 

4,0(10 

o,UUu 

2000 

11)00 

0 

57?" 

560 

6,000 

10,612 

10,584 

21.   Horse    stables    under    supervision    and 
permits. 


Owing  to  the  increasing  and 
dangerous  sewage  pollution  of 
the  rivers  and  harbors  along  the 
City's  waterfront,  sanitary  safety 
has  required  the  closing  of  many 
of  the  public  bathing  establish- 
ments on  various  beaches. 

To  meet  the  pressing  need  for 
bathing  facilities  which  form 
one  of  the  best  resources  for 
recreation  and  personal  hygiene, 
a  number  of  new  open-air  bath- 
ing pools  have  been  built  and 
operated  in  accordance  with 
high  standards  of  cleanliness  in 
all  the  boroughs  of  the  City. 


BATHINC 

1913 

1914 

1915 

1916 

1917 

ran 

m 

m 

^^ 

100 

DO 

0 

Z64- 

237 

zoo 

178 

160 

22.   Public    bathing    beaches. 


23.  Outdoor   public    bathing   pools. 


12 


1917. 

2: 

c« 

> 

O 
Z2 

<_2 

U-J 

LBS. 
30000 

ZQ,0OQ 

- 

n 

0 

- 

j  '; 

A  new  source  of  wholesome 
food  supply,  namely  horse  meat, 
has  been  made  available  during 
the  past  year  and  the  rapid  ex- 
tension of  the  business  even 
under  the  most  rigid  restrictions 
fully  justifies  this  innovation. 
Meat  at  eight  to  sixteen  cents 
per  pound  is  a  boon  to  many  and 
a  palatable  luxury  to  those  who 
are  wise  and  unprejudiced. 


!-).    Pounds     of     horse-meat     sold     at     6 
cents — IS    cents   a    pound. 


13 


RESULTS. 

To  what  degree  education, 
inspection,  law  enforcement,  or 
the  general  improvement  in  the 
standards  of  living  is  respons- 
ible, is  of  less  interest  to  the 
householder  and  business  man  or 
mother  of  a  family,  than  to  the 
technical  epidemiologist  or  ad- 
ministrator. The  records  here 
presented  are  certainly  encourag- 
ing and  will  undoubtedly  be  stud- 
ied with  interest.  The  general 
death  rate,  the  infant  mortality 
rate,  the  death  rate. for  children 
under  five,  and  the  death  rates 
of  many  of  the  more  important 
preventable  diseases  show  a 
gratifying  reduction. 


RAIL 

IK 

1913 

1914 

I9I&' 

:i9ffi 

w. 

W.. 

\l 

10, 

8. 

■6, 

/i 

n-. 

1 

0, 

J4.ZI 

tU3 

13.93 

13.89 

I3.7S 

25.  Crude   death   rate   from   all   causes,   at 
all   ages   per   1,000   population. 


RATE 


26.  Death    rate    under    1    year    per    1,000 
reported    births. 


RATF 

1913 

1914 

1915 

1916 

1917 

40, 

ft 

20. 

i 

i 

10. 

s 

0. 

376 

315 

35.  i 

33.6 

30.2 

27.  Death  rate  under  5  years  from  all 
causes  per  1,000  population  under 
S   years.  . 


14 


WffF 

1911 

1915 

1916 

1917 

80 

60      "* 

40 

1 

n 

o  ! 

71 

67 

72 

55 

58 

PATF 

1913 

1914- 

1915 

1916 

1917 

Oft 

.06 

%s. 

04 

\ 

0?, 

,  09 

.07 

.06 

.06 

.04 

.04 

28.  Death    rate    from    Diarrhoeal    Diseases       29.   Death    rate    from    Typhoid    per    1,000 
under  5  years,  per  1,000  population  population, 

under   5   years. 


m 

1914 

\% 

1916 

1917 

RATF 

1? 

Oft 

04 

00 

.12 

.11 

M 

.09 

.10 

RATF 

1913 

1914 

1915 

1916 

1917 

10 

0# 

06 

04 

0? 

SO 

.10 

M 

.05 

M 

.02 

30.  Death    rate    from    Measles    per    1,000        31.   Death    rate    from    Scarlet    Fev'er    per 

population.  1,000    population. 


RATE 

1913 

1914 

1915 

1916 

I9I7 

2.00 

1 
\        i 

LOT 

1.20 

.80 

.40 

.00 

1.65 

(.67 

1.61 

1.50 

I.54 

32.   Death  rate  from  Diphtheria  and  Croup         33.   Death   rate   from   Pulmonary  Tubercu- 


per     1,000     population. 


losis   per   1,000   population. 


15 


mtf 

1913 

\m 

1915 

1916 

1917 

04 

03 

\ 

It?, 

V 

/ 

01 

00 

.04 

.w 

.02 

.03 

.03 

1.93     1. 


34.  Death  rate  from  Cerebro-Spinal  Men-       35.  Death   rate   from  Broncho  and  Lobar 
ingitis   per   1,000   population.  Pneumonia  per   1,000  population. 


HORSES 
17.00 

1913 

1914 

1915 

1916 

1917 

1000 

800 

m 

.  400 

?oo 

0 

1138 

1,153 

704 

403 

670 

DOGS 

1913 

1914 

1915 

1916 

191? 

200 

15? 

100 

50 

0 

149 

Z07 

103 

il 

32 

36.  Horses   condemned  for  Glanders. 


37.  Rabid  dogs  collected  and  destroyed. 


Education  and  a  judicious  use 
of  the  police  power  has  reduced 
the  number  of  instances  in  which 
people  have  been  bitten  by  un- 
muzzled or  improperly  muzzled 
dogs. 


person: 

filTTFW 

1913 

1914 

19(5 

1916 

1917 

wrttli 

5000 

4000 

W 

?ooo 

1000 

0 

4,366 

4,462 

3,460 

3,Z« 

3,193 

38.  Persons   bitten   by   dogs. 


16 


MTF 

1913 

1914 

1915 

1916 

1917 

ffl 

M 

dfi 

\ 

i     d 

/^ 

^/ 

/ 

M 

V 

.07 

.oO 

.08 

.05 

.07 

06 

.08 

39.   Death  rate  from  Whooping  Cough  per 
1,000  population. 


U 


n 


is- 


14 


~W 


4  0.  Death  rate  from  Acute  Bronchitis  per 
1,000  population. 


In  whooping  cough,  acute 
bronchitis  and  street  accidents, 
each  of  which  is  properly  con- 
sidered a  preventable  cause  of 
death,  the  death  rate  has  re- 
mained the  same  and  these  con- 
stitute so  considerable  a  propor- 
tion of  all  deaths,  that  special 
effort  must  continue  to  be  di- 
rected against  each  of  them, 
through  educational  means 
chiefly,  aided  especially  in  the 
case  of  street  accidents  by  ade- 
quate provision  for  playgrounds 
for  children,  and  by  some  rem- 
edy for  many  of  the  intolerable 
conditions  of  street  traffic. 


RATE 
.IS 

1913 

1911 

1915 

1916 

1917 

10 

-v 

■w^ 

■^^ 

.05 

,00 

A 

.11 

.10 

.12 

41.  Death   rate   from   street  accidents   per 
1,000  population. 


17 

Not  only  have  there  been 
fewer  deaths  from  many  of  the 
preventable  diseases  (which  ?ftOQ 
might  of  itself  be  an  indication 
merely  of  a  decreased  virulence 
of  the  disease,  or  of  a  more  suc- 
cessful quality  of  medical  care 
of  the  patients)  but  there  has 
been  a  reduction  in  the  actual 
prevalence  of  many  of  the  com- 
mon preventable  diseases  as 
well.  One  must,  of  course, 
always  acknowledge  the  proba- 
bility of  incomplete  reporting  of 
these  notifiable  diseases. 


Cases  of  Typhoid  Fever  rep  o  I  e 


■  I'- 

1913 

m 

19)5 

1916 

m 

ll 

^^ 

Rj 

\ 

10 

5 

\ 

/ 

10       24 


•- 


4-3.   Cases    of    Small   Pox   reported- 


Cases  of  Scarlet  Fever  nz-.r'-iz. 


18 


CASES 

?<HQ0O 

1913 

\m 

1915 

1916 

1917 

IROOO 

ifiono 

/s 

iflooo 

/ 

f 

\ 

k 

1P.OOO 

V. 

"**. 

10  000 

1 
0 

14,535 

17.129 

15,279 

13,521 

12,811 

thm 

1913 

1914 

1915 

1916 

1917 

?f),00( 

n,m 

15,000 

10,000 

5,00(1 

0 

22,671 

Z1.604 

ze.141 

19,297 

17,753 

45.   Cases    of    Diphtheria    and    Croup    re-       46.   Cases      of      Pulmonary      Tuberculosis 
ported.  reported. 


48.  Cases 


Cerebro-Spinal 
reported. 


Meningitis 


Measles  is  a  disease  of  such 
universal  prevalence  and  with 
such  extreme  periodic  biennial 
or  triennial  incidence  that  no 
record  extending  over  four  or 
five  years  can  give  any  correct 
impression  as  to  increases  or 
diminution;  there  is,  however, 
no  good  reason  to  believe  that 
any  material  impression  has 
been  made  upon  its  incidence  or 
severity  by  departmental  ser- 
vice. 

Meningitis  is  also  a  disease  of 
irregular  prevalence  and  the 
wide  periods  at  which  it  becomes 
epidemic  in  character  renders 
any  record  for  a  period  of  five 
years  of  little  importance.  The 
disease  has,  however,  shown  a 
tendency  to  increase  in  various 
cities  throughout  the  country  in 
the  past  twelve  months. 

Whooping  cough  is  so  incom- 
pletely reported  that  records  of 
its  incidence  are  of  no  value. 


19 

The  reporting  of  syphilis  and  gonorrhoea  is  not  yet  suffi- 
ciently common  or  complete  among  physicians  outside  of  hospital, 
dispensary  and  institution  practice,  to  be  used  as  a  sound  basis 
for  judging  of  the  extent  of  their  prevalence  throughout  the  City, 
but  the  record  of  the  past  five  years  is  interesting  even  though 
incomplete. 


rnsfii 

1913 

1914 

1915 

1916 

1917 

?l),0Q() 

*V 

Ifi.OOO 

r 

0 

/** 

v* 

IP.000 

1 

m 

1 

MOP 

0 

10,623 

Z1.1Z8 

17,335 

zo,\u 

18,666 

CASTS 

1913 

1914 

1915 

I91fr 

1917 

10,000 

8000 

, 

r 

A 

ftOOO 

/ 

V 

«■ 

4,000 

(W 

0 

6853 

9.5Z6 

9709 

6,12) 

6.Z&4 

49.   Cases  of   Syphilis   reported. 


SO.   Cases    of    Gonorrhoea    reported. 


Other  Accomplishments. 

Of  the  nine  bureaus  of  the  Department,  the  work  of  the 
Sanitary  Bureau,  the  Bureau  of  Food  and  Drugs,  and  the  Bureau 
of  Public  Health  Education,  can  least  well  be  expressed  in  figures 
or  concrete  results. 

So  far  as  the  last  named  is  concerned,  it  must  be  remembered 
that  every  agent  of  the  Department  is  in  effect  an  educator,  a 
teacher  of  the  laws  of  hygiene,  and  the  ways  of  avoiding  disease. 
The  notes  and  articles  in  the  daily  press,  too  often  taken  as  the 
main  educational  effort  of  the  Department,  are  but  the  echo  of  a 
great  volume  of  organized  health  teaching,  which  permeates  to 
and  through  schools,  settlement  houses,  Y.  M.  C.  A.'s,  shops  and 
homes. 

A  good  share  of  the  credit  for  some  of  the  reduction  in  disease 
and  deaths  above  recorded,  especially  such  as  is  due  to  improper 


20 

disposal  of  human  discharges  and  to  unhygienic  conditions  of 
shops  and  living  premises  must  be  given  to  the  Sanitary  Bureau, 
and  it  is  by  the  work  of  this  Bureau  that  the  control  of  the  breed- 
ing of  flies  and  mosquitoes  has  been  so  far  accomplished. 

The  outstanding  accomplishments  of  the  Bureau  of  Food  and 
Drugs  have  been:  (1)  The  effective  control  of  the  milk  supply, 
so  that  at  present  98  per  cent,  of  the  milk  consumed  in  New  York 
City  is  pasteurized,  the  remainder  being  of  a  grade  safely  used 
raw.  In  1913,  only  60  per  cent,  of  the  milk  supply  was  pasteur- 
ized and  decidedly  less  than  2  per  cent,  was  safe  for  use  raw. 
(2)  The  extension  of  its  inspection  sen-ice.  so  as  to  control, 
under  suitable  regulations,  even-  establishment  in  the  city  where 
food  is  stored,  handled  or  prepared.  (3)  The  scoring  and  issu- 
ing of  permits  to  all  restaurants  and  public  eating  places,  under 
conditions  of  service,  equipment  and  materials,  which  gives  the 
public  a  protection  never  attempted  before  1915. 

A  little  contribution  to  the  sen-ice  of  the  City  and  a  modest 
improvement  in  results  is  recorded. 

There  remain  great  opportunities  open  to  the  next  admin- 
istration for  immediate  attack.  Four  are  of  great  importance 
and,  if  met  with  vigor  and  generosity,  will  not  only  contribute 
much  to  health  in  the  homes  of  the  wage  earners,  but  will  also 
reduce  the  burden,  upon  the  taxpayers,  which  otherwise  will 
result  because  of  inevitable  disability  and  disease.  I  refer  to  the 
extension  of  (I)  Care  of  expectant  mothers;  (2)  Periodic  medi- 
cal examinations  and  supervision  during  sickness  of  all  city  em- 
ployees :  (3)  Adequate  facilities  for  the  diagnosis  and  treatment 
of  syphilis  and  gonorrhoea,  and  (4)  Sufficient  supervision  of  the 
hazards  of  industry,  to  prevent  avoidable  diseases  of  occupation. 


Public  health  is  purchaseable.     Within  natural  limitations  a 
community  can  determine  its  ozi'n  death  rate. 


COLUMBIA   UNIVERSITY    LIBRARIES 

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expiration  of  a  definite  period  after  the  date  of  borrowing,  as 
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DATE  BORROWED 

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DATE  DUE 

£\        ' 

!  *  \ 

C28  (747)  M1GO 

{  GAYLAMOUNT 

>  PAMPHLET  BINDER 


[|         Manufadund  hy 

}  •AYLORDBROS.  I«. 
5  Syracuse,  N.  Y. 

|  Stoefcten,  CM. 


P./J.22.G1 


K482 
1917 


£iev/  York  (City)   Dept.    of  health. 
.f'£.cts   and  figures   showing  the 
quantity  and   cost   of  the  work 


C,  U.  BINDERY 


$E 


m\zzt\ 


1911 


